Foodborne Diseases Active Surveillance (FoodNet)

On this page:

• Surveillance Activities
• Data
• Attribution
• Publications

Foodborne Diseases Active Surveillance Network (FoodNet) is a core component of U.S. Centers for Disease Control and Prevention (CDC) Emerging Infections Programs network (EIP), a collaboration between CDC, state health departments, and universities. (For foodborne disease outbreak reporting and investigation go to foodborne outbreaks.)

FoodNet is an active laboratory and population-based surveillance system to monitor the incidence of foodborne diseases of local and national public health importance.

Objectives are to:

• Determine the burden of foodborne illness
• Monitor trends in the burden of specific foodborne illnesses over time
• Attribute the burden of foodborne illness to specific foods and settings
• Develop and assess interventions to reduce the burden of foodborne illness

FoodNet Ongoing Surveillance Activities

Surveillance is conducted for eight bacterial and one parasitic pathogen:

• Campylobacter
• Cyclospora
  
• Enterotoxigenic Escherichia coli (ETEC)
• Listeria
• Salmonella
• Shiga toxin producing Escherichia coli (STEC) O157 and non-O157
• Shigella
• Vibrio
• Yersinia

Activities include:

• Active laboratory-based surveillance for foodborne pathogens
  The core of FoodNet is population-based active surveillance of clinical laboratories in the participating sites. Clinical laboratories that test stool samples are contacted regularly to collect information on all of laboratory-confirmed cases of foodborne illness.
• Survey of the population
  The population survey is conducted to precisely estimate the burden of acute diarrheal illness and to describe the frequency of important exposures.
• Survey of clinical laboratory practices
  The periodic laboratory survey is conducted to determine which pathogens are included in routine bacterial stool cultures, which tests must be specifically requested by the physician, and which specific techniques are used to isolate the pathogens.
• Survey of physicians
  The periodic survey is conducted to understand knowledge, attitudes and practices of physicians.
• Disease attribution

FoodNet Data

• FoodNet Data and Annual Reports
• List of FoodNet Case-Control and Cohort Studies (pdf)
• FoodNet Special Studies, by pathogen
• CDC special update on foodborne illness: Vital Signs - Making Food Safer to Eat

Attribution

"Attribution" refers to attempts to assign illness caused by various enteric pathogens to specific food commodities. Such attribution may be done at several levels, including animal reservoirs (e.g., cattle), food-processing plants (e.g., slaughterhouses or packaging plants), retail foods (e.g., ground beef), or even specific foods eaten (e.g., tacos).

In an outbreak of foodborne disease, the specific food source may be learned with certainty. In the case of "sporadic" cases of foodborne illness, however, food sources cannot be attributed with certainty, but must be inferred. Such inferences may be based on various data sources, including types of pathogens found in various food animals, the foods implicated as causes of outbreaks, or even by asking experts what their best guesses are.

Below are links that highlight some of the efforts being made by FoodNet to attribute enteric illnesses to food sources and to offer links to efforts being made by other experts in foodborne illness.

CDC Data

• CDC National Outbreak Reporting System Dashboard
  
• CDC FoodNet Surveillance Data
  
• CDC outbreak surveillance summaries
• CDC National surveillance of bacterial foodborne illnesses
• National Antimicrobial Resistance Monitoring System (NARMS)
• FoodNet Population Survey: Atlas of Exposures
• CDC Salmonella Atlas

Other Data

• IFSAC-2021 source attribution estimates: Salmonella, E.coli 0157, Listeria monocytogenes, Campylobacter (pdf)
  
• IFSAC-2020 source attribution estimates:Salmonella, E.coli 0157, Listeria monocytogenes, Campylobacter (pdf)
  
• IFSAC 2019 source attribution estimates: Salmonella, E. coli  O157, Listeria monocytogenes, Campylobacter (pdf) 
  
• FSAC-2018 source attribution estimates: Salmonella, E.coli 0157, Listeria monocytogenes, Campylobacter (pdf)
  
• IFSAC-2017 source attribution estimates: Salmonella, E. coli O157, Listeria monocytogenes, Campylobacter (pdf) 
  
• IFSAC-2016 source attribution estimates: Salmonella, E.coli 0157, Listeria monocytogenes, Campylobacter (pdf)
  
• IFSAC-2015-source attribution estimates: Salmonella, E.coli 0157, Listeria monocytogenes, Campylobacter (pdf)
• IFSAC-2014 source attribution estimates: Salmolnella, E. coli O157, Listeria monocytogenes, Campylobacter (pdf)
  
• IFSAC-2013 source attributions: Salmonella, E. coli O157, Listeria, Campylobacter (pdf)
  
• FSIS datasets 
• USDA Food Availability Data
• USDA Foodborne Outbreak Investigation Annual Reports
  
• USDA Food Safety Inspection Service microbiologic data
• USDA Economic Research Service Annual Products
  
• What We Eat in America (National Health and Nutrition Examination Survey)
• FoodRisk.org (clearinghouse for quantitative risk assessment for information, Joint Institute for Food Safety and Applied Nutrition)
• World Tourism Organization statistics
  

Links

• Attributing salmonellosis cases to foodborne, animal contact and waterborne routes using the microbial subtyping approach and exposure weights
  
• Zoonotic Diseases (Diseases from animals)
• Emerging Pathogens Institute - University of Florida
• CDC FoodNet
  
• World Health Organization Foodborne Diseases webpage

Food Safety Regulations

• FDA Guidance and Regulation
• FDA Egg Safety Final Rule

FoodNet Publications

https://www.cdc.gov/foodnet/publications/index.html

Articles of Interest

• CDC Annual Summaries of Foodborne Outbreaks
• Bonner KE, Carter M, Zielinski C, Morey K, McLitus L, DeBess E, Hatch J, Leman R. Notes from the Field: Enteropathogenic Escherichia coli. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8989374/
• Besser J, Singer R, Jervis RH, Boxrud D, Smith K, Daly ER; Members of the APHL, CSTE Enteric Disease Exclusion Policies Workgroup. Laboratory Criteria for Exclusion and Readmission of Potentially Infectious Persons in Sensitive Settings in the Age of Culture-Independent Diagnostic Tests: Report of a multidisciplinary workgroup. J Food Prot. 2023 Dec;86(12):100173. https://www.sciencedirect.com/science/article/pii/S0362028X23068576?via%3Dihub 
• Patel K, Stapleton, GS, Trevejo RT, Tellier WT, Higa J, Adams JK, Hernandez SM, Sanchez S, Nemeth NM, Debess EE, Rogers KH, Mete A, Watson KD, Foss L, Low MSF, Gollarza L, Nichols M. Human Salmonellosis Outbreak Linked to Salmonella Typhimurium Epidemic in Wild Songbirds, United States, 2020-2021. Emerg Infect Dis. 2023 Nov;29(11):2298-2306. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10617330/ 
  
• Hines JZ, Jagger MA, Jeanne TL, West N, Winquist A, Robinson BF, Leman RF, Hedberg K. Heavy precipitation as a risk factor for shigellosis among homeless persons during an outbreak - Oregon, 2015-2016. J Infect. 2018 Mar;76(3):280-5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8596496/
  
• Hines JZ, Bancroft J, Powell M, Hedberg K. Case Finding Using Syndromic Surveillance Data During an Outbreak of Shiga Toxin-Producing Escherichia coli O26 Infections, Oregon, 2015. Public Health Rep. 2017 Jul/Aug;132(4):448-50. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5507422/ 
• Hines JZ, Pinsent T, Rees K, Vines J, Bowen A, Hurd J, Leman RF, Hedberg K. Notes from the Field: Shigellosis Outbreak Among Men Who Have Sex with Men and Homeless Persons - Oregon, 2015-2016. MMWR Morb Mortal Wkly Rep. 2016 Aug 12;65(31):812-3. https://www.cdc.gov/mmwr/volumes/65/wr/mm6531a5.htm

See Also

• Oregon Administrative Rules (OAR) related to food safety
• Foodborne disease resources